The Truth Behind Fertility Treatments
By Siti Salihah
When IVF comes up in conversations, a lot of myths and stigma tend to follow. IVF is often associated with various assumptions—it’s only for certain situations, it’s incredibly expensive, and so on. There’s also the notion that it’s only for couples facing serious fertility issues or as a last resort. But what’s the truth behind IVF?
To clear things up, we spoke with Dr. Raymond Lim, a specialist in Obstetrics & Gynaecology with a subspecialty in Reproductive Medicine. With extensive experience in fertility management, advanced reproductive techniques, and minimally invasive surgeries, Dr. Raymond provides expert care in women’s health. Having trained in the UK, he’s well-placed to address the myths surrounding IVF and fertility treatments.
#1 Male infertility is less common than female infertility.
Dr. Raymond Lim Chung Siang: False. Male infertility accounts for 40–50% of cases where a couple is infertile or subfertile. It’s important to distinguish between infertility and subfertility—infertility means a person has difficulty conceiving, whether naturally or with medical help, while subfertility refers to having trouble conceiving naturally but still being able to do so with assistance.
#2 If a couple is unable to conceive after trying for a long time, one of them must be sterile.
Dr. Raymond: False. Infertility means there’s difficulty in conceiving, but there’s still a chance of pregnancy, especially with medical assistance. On the other hand, sterility means there is no chance of conceiving using your own sperm or eggs, and this is very rare—affecting less than 1% of couples. Infertility can be caused by many factors, such as irregular intercourse, poor timing, diet, hormonal imbalances, or previous surgeries. Therefore, the notion that one of the partners must be sterile is incorrect.
#3 Fertility treatments always lead to twins or triplets.
Dr. Raymond: This is actually a bit of a mixed answer. From an obstetrics angle, yes, fertility treatments do often result in multiple pregnancies. However, from a gynaecology perspective, it’s potentially no. In general, assisted reproductive techniques (ART) contribute to most of the current multiple pregnancies. But, the likelihood depends on the clinician’s practice. For example, how many embryos are implanted during IVF. In ethical IVF practice worldwide, the consensus is to only implant one or two embryos to reduce the risk of multiples. But if the clinic practices unethically or operates in an unregulated environment, more than two embryos may be implanted to increase the chances of pregnancy, which could lead to higher-order multiples. For another type of assisted reproductive treatment, intrauterine insemination (IUI), the risk of multiple pregnancies is less predictable, and while it’s closer to natural conception, we still can’t avoid it entirely. Ultimately, the outcome is dependent on the patient’s response and the technician’s practice.
#4 ‘Designer babies’ are possible in Malaysia.
Dr. Raymond: Preimplantation genetic testing (PGT) was initially developed to reduce the creation of offspring with inheritable diseases. That was its primary purpose. In Malaysia, the Ministry of Health states that PGT should be used for only severe and life-threatening genetic diseases.
It would be unethical to analyse and select the inherited characteristics of embryos (e.g intelligence, height, hair and eye colour), any social or physiological characteristics or any other conditions that are not associated with disability or a serious medical condition. Basically if misused, PGT can be used to select the sex of the baby or even choose certain physical traits.
Can intelligence or physical traits be selected?
I’m not sure about intelligence—how do we define intelligence? However, selecting physical features is definitely possible. For example, choosing features like a stronger body or a very pretty face can be done through PGT. However, it would be ethically wrong to do so.
#5 Once you start IVF, you have to commit to multiple rounds.
Dr. Raymond: False. It really depends on the reproductive health of both partners. If everything is normal, IVF should typically work within one round.
But if everything is normal, why did they need IVF in the first place?
There are a few reasons for this:
- Sometimes, the cause of infertility is unexplained.
- It could be due to psychological factors affecting intercourse.
- It might be related to hormonal imbalances, which can be treated with medication. Hormonal medication is part of IVF treatment. The imbalance could be in either the woman’s or the man’s body, and in IVF, we use external hormones that mimic the body’s natural hormones to help regulate these levels.
#6 Sperm quality doesn’t matter as long as IVF is an option.
Dr. Raymond: False. Sperm quality matters. In our fertility practice, male infertility accounts for 40-50% of the difficulty couples face when trying to conceive, which is higher than the 15-20% that’s often quoted in textbooks.
The reasons for poor sperm quality can include:
- Lifestyle factors: Like diet, lack of exercise, and consuming too much fast food.
- Medical conditions affecting the man.
- Surgical procedures the man may have undergone.
- Radiation exposure, which can affect sperm quality as well.
#7 Different IVF methods in studies make it hard for experts to agree on one ‘proven’ approach.
Dr. Raymond: There are several methods that can be used for each couple that is engaging in IVF treatments. Each method has its reason why it may suit best for that particular couple. There is no ‘One size shoe fits all’. Each individual has to be assessed in detail prior to the agreed treatment protocol. Even then, sometimes it does not work in the first cycle necessitating the adoption of different protocols that are not generally used in IVF.
IVF is an ever-changing and developing fields and it is of great benefits that meetings are held by international bodies like ESHRE, ASRM, ASPIRE etc. which present new protocols used by some specialists that may be used by ones’ Fertility Specialist to improve the success of a couple to conceive.
Whether it’s the myth that male infertility isn’t a big deal or the assumption that IVF always results in twins, the truth is far more nuanced. IVF is a highly personalised process that depends on both partners’ health, specific challenges, and even the clinic’s approach. While it can be life-changing for many couples, it’s important to separate fact from fiction and truly understand what IVF involves. The more we clear up these misconceptions, the less intimidating the process feels—and the more informed hopeful parents can be as they navigate their journey.
To learn more, catch Part 2 of our series of Debunking False IVF Myths.
